Request a Certificate for Assigned Risk / VDAC

Attention: For fast, 24-hour access, use the OAR online service.  OAR is the online Assigned Risk Services for Assigned Risk and VDAC - Massachusetts.  It's offered through the Workers' Compensation Rating & Inspection Bureau and allows you to verify coverage and request a certificate of insurance.
OAR Log-in

If you prefer to request a certificate directly from A.I.M. Mutual, please fill out the form below.

Please provide all of the requested information, including the facsimile number(s) of the person or persons to whom the Certificate of Insurance should be issued. If this form is fully and accurately completed, the Certificate of Insurance will be issued and distributed by facsimile to each fax number provided below, within two (2) business days of the carrier’s receipt. 

1. Name, address, telephone number and facilimile number or email address of the INSURED:
2. Name, address, telephone number and facilimile number or email address of the CERTIFICATE HOLDER:
3. Name, address, telephone number and facilimile number or email address of the PRODUCER:
4. Policy Number, Policy Effective Date and Policy Expiration Date

If a Certificate of Insurance is needed for more than one policy term, provide the Policy Number,
Effective Date and Expiration Date for each policy term.
If the policy has not yet been issued, you must attach a copy of the Notice of Assignment
5. List any special requests for optional coverages / endorsements (see below for listing of coverages available
in the pool and the conditions of availability) or additional information (including changes in exposure not yet
reported to A.I.M. Mutual) that will assist us in the issuance of the Certificate of Insurance.
NOTE: An additional insured(s) shall not be listed on any Certificate of Insurance unless such additional
insured(s) is a named insured on the policy.